Is a modern day “Typhoid Mary” the link to a North Carolina Salmonella paratyphi B Outbreak?

As many as thirty-four cases of Salmonella paratyphi B have been identified in North and South Carolina, Tennessee and New York since February 28th according to the North Carolina Buncombe County Department of Health.

According to the CDC, humans are one of the only known reservoir sources of Salmonella paratyphi B. Salmonella paratyphi B is most often acquired through consumption of water or food that has been contaminated by feces of an infected person or a chronic, asymptomatic carrier. The most famous example of a human chronic carrier of Salmonella was “Typhoid Mary,” an asymptomatic Irish-American cook linked to 54 cases and four deaths in nine different typhoid fever epidemics in New York City during the early 1900s.

Worldwide some six million cases of Salmonella paratyphi are estimated to occur annually. However, only approximately 150 cases of Salmonella paratyphi are reported each year in the United States, most of which are in recent travelers.

The incubation period of Salmonella paratyphoid B is longer that other Salmonella with onset of infections ranging from 6–30 days. The onset of illness is increasing fatigue and a fever that increases daily from low-grade to as high by the third to fourth day of illness. A rash of rose-colored spots can occasionally be seen on the trunk. Untreated, the disease can last for a month. The serious complications of Salmonella paratyphoid B generally occur after 2–3 weeks of illness and may include intestinal hemorrhage or perforation, which can be life threatening.